Many Tax Law Changes over Multiple Years are included in the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act.The Patient Protection and Affordable Care Act and the related Health Care and Education Reconciliation Act (which are collectively referred to as the healthcare legislation) were signed into law in March 2011. Lots of tax changes are included in the laws. Some have nothing to do with healthcare, some won't kick in for several years, some are effective right now, and some are even retroactively effective.